Unusual Length of Pedicle: Pedunculated Squamous Papilloma of Uvula Causing Unusual Dysphagia of Long Duration in a Child of 10 Years

Benign oropharyngeal tumors are far less common compared to malignant tumors. Oropharyngeal papilloma is present in adults. Squamous papillomas are exophytic masses of oral cavity. When they occur on the palate they are most often asymptomatic and benign. Pedunculated squamous papillomas usually arise from the soft palate, tonsil, or the epiglottis. These lesions can sometimes prove to be fatal. A case of pedunculated squamous papilloma, arising from the laryngopharynx, the clinical presentation, the site of origin, and the size of the lesion were quite unusual. The narrow base of the pedicle made the intraoral excision possible. But here, we present a case of a 10-year-old boy who had history of dysphagia of 3-year duration for solid food and he was comfortable only in squatting position the reason being squamous papilloma of uvula (unusual site) atypically because of astonishing length of pedicle (2.3 inches). 1. Introduction Benign oropharyngeal tumors are far less common compared to malignant tumors. Oropharyngeal papilloma is present in adults [1]. Squamous papillomas are exophytic masses of oral cavity. When they occur on the palate they are most often asymptomatic and benign [2]. Pedunculated squamous papillomas usually arise from the soft palate, tonsil, or the epiglottis. These lesions can sometimes prove to be fatal. A case of pedunculated squamous papilloma, arising from the laryngopharynx, the clinical presentation, the site of origin, and the size of the lesion were quite unusual. The narrow base of the pedicle made the intraoral excision possible. 2. Case Report A 10-year old boy presented with 3 years of unusual dysphagia. He also reported choking sensation while eating solid food and was comfortable only in squatting position. He had a history of elongated pedunculated lesion. The patient had difficulty in swallowing food for 7 years because of local irritation in throat and dry cough. There was no relevant history of throat pain, fever, and any other infection. On throat examination extending from uvular tip a fine strand of tissue over 2.3 inches in length ending in a small disc-like mass-pedunculated (3 × 2？cms) basal part of uvula appeared to be normal. This caused difficulty in swallowing (in the laryngeal region). Excision was simple (see Figure 1). Figure 1: Clinical photo: arrow showing pedunculated squamous papilloma of uvula. Grossly. On examination the disc-like mass revealed rough and papillary projections giving a provisional diagnosis of papilloma (see Figure 2). Figure 2: Macroscopic view of pedunculated squamous papilloma